JACKSONVILLE, Fla. — Mayo Clinic researchers developed an experimental nanotherapy that delivers two cancer drugs directly to brain tumors, according to a study published in Nature Communications Medicine. The strategy extended survival in preclinical models of glioblastoma, the most aggressive form of brain cancer.

The nanotechnology-based approach packages two existing cancer drugs into tiny particles engineered to cross the brain's protective blood-brain barrier and target tumor cells. In preclinical models using patient-derived tissue, combining the treatment with radiation more than doubled survival compared with untreated controls.

Glioblastoma is notoriously difficult to treat. Patients typically survive for about 15 months after diagnosis, even with the latest therapies such as surgery, radiation and chemotherapy. One major challenge is that many drugs cannot effectively reach tumors in the brain, and those that do often lose effectiveness as tumors develop resistance.

The new approach uses small lipid-based particles, known as liposomes, to carry and deliver a combination of drugs — everolimus or rapamycin and vinorelbine — directly to cancer cells, using a new tumor-targeting strategy. By ensuring both drugs reach the same cells at the same time, researchers aim to improve tumor-killing effects while reducing the toxic side effects associated with higher drug doses.

"Glioblastoma remains extremely difficult to treat due to drug resistance and limited drug delivery to the brain," says Debabrata (Dev) Mukhopadhyay, Ph.D., a professor of biochemistry and molecular biology at Mayo Clinic in Florida. Dr. Mukhopadhyay, a nanotechnologist, is a senior author of the study. "Our approach is designed to improve both by targeting the tumor directly and combining therapies in a way that enhances their impact."

The drug combination includes agents that interfere with tumor growth pathways and disrupt the cancer's ability to repair DNA damage, making tumors more sensitive to radiation. 

"This represents a promising direction for treating patients with glioblastoma and advancing new technologies and therapies, so we can one day improve the survival of patients with brain cancer by delivering novel cancer therapies to the brain," says Alfredo Quinones-Hiñojosa, M.D., dean of research emeritus and chair emeritus of the Department of Neurosurgery at Mayo Clinic in Florida and a senior author on the study. "Further research will be needed to determine whether these results translate to patients."

Researchers are conducting additional safety and dosing studies required before clinical trials can begin. If successful, the approach could eventually be an oral or intravenous medication used alongside standard treatments or as an option for patients whose tumors do not respond to existing therapies.

"While this work is still in development, it represents an important step toward developing more precise cancer treatments that are both more effective and less toxic, potentially improving quality of life for patients," says Dr. Mukhopadhyay.

This study was supported in part by the National Institutes of Neurologic Disorders and Stroke of the National Institutes of Health under award number R01NS129671. Read the study for a full list of authors, disclosures and funding. 

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About Mayo Clinic
Mayo Clinic is a nonprofit organization committed to innovation in clinical practice, education and research, and providing compassion, expertise and answers to everyone who needs healing. Visit the Mayo Clinic News Network for additional Mayo Clinic news.

About Mayo Clinic Comprehensive Cancer Center 
Designated as a comprehensive cancer center by the National Cancer Institute, Mayo Clinic Comprehensive Cancer Center is defining the cancer center of the future, focused on delivering the world's most exceptional patient-centered cancer care for everyone. At Mayo Clinic Comprehensive Cancer Center, a culture of innovation and collaboration is driving research breakthroughs in cancer detection, prevention and treatment to change lives.

Media contact:

• Julie Ferris-Tillman, Ph.D., Mayo Clinic Communications, newsbureau@mayo.edu

The post Mayo Clinic experimental dual-drug nanotherapy crosses the blood-brain barrier and improved survival in preclinical glioblastoma models appeared first on Mayo Clinic News Network.

DEAR MAYO CLINIC: My cousin, who's in her 30s, was recently diagnosed with colorectal cancer. I've always thought of colorectal cancer as something that affects older adults. Why are more young people being diagnosed with colorectal cancer, and is it different when it happens at a younger age?

ANSWER: For many years, colorectal cancer was considered a disease that mainly affected older adults, and screening traditionally began at age 50. Today, however, doctors are diagnosing more people in their late 20s, 30s and 40s.

This shift led to national guidelines being lowered; they now recommend 45 as the age to begin routine colorectal cancer screening. In the past, doctors believed colon polyps, small growths in the colon or rectum, typically took about 10 years to become cancerous. That understanding helped determine when screening should begin.

Colorectal cancer screening

Colonoscopy and flexible sigmoidoscopy are considered the gold standard for screening. Both require bowel preparation the day before, sedation during the procedure and someone to drive you home. These procedures also allow doctors to remove polyps during the same exam.

Stool-based tests are another option. Some look for hidden blood, while others look for cancer-related DNA. These tests generally must be done annually and, if positive, require follow-up with a colonoscopy. For people at higher risk, such as those with a first-degree relative with colorectal cancer, a colonoscopy or sigmoidoscopy is typically recommended instead of stool testing alone.

While screening is important, researchers are still working to understand why more younger adults are being diagnosed.

So far, there isn't a single explanation. In some cases, inherited conditions, such as Lynch syndrome, and inflammatory bowel diseases like Crohn's disease or ulcerative colitis, increase the risk of colorectal cancer. Researchers are studying other possible genetic, environmental and lifestyle factors, but more research is needed to fully understand the rise.

Smoking, alcohol use, higher red meat intake, lower physical activity and sedentary habits are often discussed, but much of the evidence comes from observational studies, and firm conclusions are still lacking. Researchers are also examining whether early life exposures, including during pregnancy, may play a role.

Younger adults sometimes experience delays in diagnosis because they may not yet qualify for screening and symptoms can be subtle. Some data suggest younger patients may have multiple medical visits before receiving a diagnosis, which can contribute to detection at a later stage.

Warning signs or symptoms

Symptoms that young adults should watch for include:

• A consistent change in bowel habits, such as ongoing constipation or diarrhea.
• Blood in the stool, whether bright red or dark.
• Unintentional weight loss.
• Abdominal pain that doesn't go away.
• Iron-deficiency anemia.

Some people attribute rectal bleeding to hemorrhoids, but any blood in the stool should be evaluated. Iron-deficiency anemia, particularly microcytic anemia found on blood tests, should prompt evaluation to determine whether bleeding may be occurring in the digestive tract. That workup often includes a colonoscopy.

Symptoms that persist for several days to weeks should be evaluated.

Treatment options for colorectal cancer

Treatment approaches, including surgery, chemotherapy, radiation therapy and, in some cases, immunotherapy, aren't different based on age alone. However, younger patients often face additional life considerations. Many are balancing school, careers and family responsibilities along with financial pressures. Fertility is also an important concern, since these treatments can affect the ability to have children. For that reason, fertility counseling is often discussed before treatment begins.

In certain rectal cancers, treatment strategies are evolving. Doctors are working on tailoring therapy to reduce long-term side effects while maintaining cure rates.

There's ongoing research focused on prevention, including studies of the gut microbiome and how environmental exposures may influence cancer risk. Advocacy groups such as Fight Colorectal Cancer and the Colorectal Cancer Alliance provide education and support for patients and families. They also work closely with researchers to help ensure that patients have a voice in how clinical trials are designed and conducted.

While much remains to be understood about why colorectal cancer is increasing in younger adults, awareness, timely evaluation of symptoms and appropriate screening remain key.

Christina Wu, M.B., B.Ch., M.D., Medical Oncology, Mayo Clinic in Arizona

Related posts:

• Mayo Clinic Minute: Advancing colorectal cancer care through innovation and screening
• Mayo Clinic Minute: Are colon and rectal cancers treated differently?
  
  

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5-year, multisite Mayo Clinic study finds high diagnostic accuracy, low complication rates — and a shift toward earlier-stage detection

JACKSONVILLE, Fla. — As lung cancer screening identifies an estimated 1.6 million suspicious lung nodules each year in the U.S. alone, physicians face a challenge. Most peripheral pulmonary lesions are benign, yet the malignant minority represent the leading cause of cancer death for both men and women.

A five-year, multisite study from Mayo Clinic suggests robotic-assisted bronchoscopy may provide a less invasive and more precise approach to diagnosing lung cancer.

The study evaluated 2,115 lung lesions in 1,904 patients across Mayo Clinic campuses in Jacksonville; Phoenix; and Rochester, Minnesota, between 2019 and 2024. Researchers reported 85% sensitivity for malignancy and 76.9% accuracy, or a strict diagnostic yield, under newly standardized national criteria. They also reported a complication rate of 2.8%.

Since adoption of robotic bronchoscopy, the proportion of lung cancers diagnosed at an early stage at Mayo Clinic increased from 46% in 2019 to nearly 69% by mid-2024. While lung cancer was caught earlier, diagnoses at advanced stages decreased from 54% to 31% in 2024.
 
"Lung cancer survival depends heavily on early detection," says Sebastian Fernandez-Bussy, M.D., the James C. and Sarah K. Kennedy Dean of Research at Mayo Clinic in Florida and the lead author of this Mayo Clinic Proceedings study. "Technologies that allow us to diagnose and even treat disease earlier — and with fewer complications — can help improve survival."

Journalists: Broadcast-quality soundbites with Dr. Fernandez-Bussy along with b-roll of a robotic-assisted bronchoscopy are available in the downloads at the end of the post. Please courtesy: "Mayo Clinic News Network.”

A complex diagnostic decision

Lung cancer generally starts with a suspicious pulmonary nodule. When that is detected through screenings, a lung biopsy may be required to confirm the diagnosis.

Shape-sensing robotic-assisted bronchoscopy, cleared by the Food and Drug Administration in 2019, allows physicians to perform as many biopsies needed to be able to gather enough tissue for diagnosis and molecular markers that will further guide an individualized treatment approach. This technology provides physicians the precision and stability to sample multiple suspicious nodules throughout both lungs. By adding endobronchial ultrasound, physicians also can perform precise staging for the immune system glands, or mediastinal lymph nodes, all in one procedure.

When combined with real-time 3D imaging or cone beam CT scans, the system also helps physicians confirm the precise placement of the small tool within lesions before biopsy.
 
"This technology really has been a game-changer for diagnosing lung cancer earlier," says Dr. Fernandez-Bussy.

In this study, the researchers reported that 56% of lesions sampled were malignant. Twenty-one percent were definitively benign, and 23% were nondiagnostic under strict criteria.

The study applied updated strict diagnostic yield definitions from the American Thoracic Society and American College of Chest Physicians, which exclude certain follow-up data that previously reported higher success rates.

Looking ahead

Robotic-assisted bronchoscopy platforms are increasingly being paired with endobronchial therapies, including pulsed electric field ablation, a minimally invasive treatment for patients who are not eligible for surgery or radiation. Mayo Clinic has begun to offer diagnosis, staging and treatment during a single procedure.
 
"I call this the 'single anesthetic lung surgery pathway,' and it means fewer trips to the hospital, less time away from family and shorter recovery times," says coauthor Janani Reisenauer, M.D., chair of thoracic surgery at Mayo Clinic in Rochester, Minnesota, who has been involved in clinical trials that deliver cancer treatment within minutes of diagnosis.

Five-year survival for localized lung cancer approaches 67%, compared with approximately 12% for metastatic disease. National guidelines recommend timely evaluation and treatment after diagnosis. As lung cancer screening expands and more nodules are detected, demand for precise, minimally invasive diagnostic approaches is expected to grow.
 
This study illustrates the impact of research with patient-contributed biospecimens, and their associated data, in driving discoveries and advancing cures. Mayo Clinic's Bioresource initiative is now accelerating the pace of such discoveries by expanding researcher access to valuable biospecimens.

Review the study for a complete list of authors, disclosures and funding.
 
Additional Link: Dr. Bussy's work reduces need for transplant in advanced lung disease patients - Mayo Clinic

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About Mayo Clinic
Mayo Clinic is a nonprofit organization committed to innovation in clinical practice, education and research, and providing compassion, expertise and answers to everyone who needs healing. Visit the Mayo Clinic News Network for additional Mayo Clinic news.

Media contact:

• Julie Ferris-Tillman, Mayo Clinic Communications, newsbureau@mayo.edu

The post Robotic-assisted bronchoscopy study of more than 2,000 lung lesions suggests safer, faster path to diagnosing lung cancer (VIDEO) appeared first on Mayo Clinic News Network.

When surgery isn't an option, a liver transplant may be a lifesaving alternative. Mayo Clinic leads in this approach, combining expertise in oncology and transplantation to offer new hope for patients with advanced colorectal cancer.

Dr. Kris Croome, a Mayo Clinic transplant surgeon, explains how expanding treatment options improves outcomes.

Watch: The Mayo Clinic Minute

Journalists: Broadcast-quality video (1:05) is in the downloads at the end of this post. Please courtesy: "Mayo Clinic News Network." Read the script.

Learning that colorectal cancer has spread to the liver can be overwhelming. Because the liver is the most common site of spread, affecting about half of patients, a liver transplant may offer hope when other treatments aren't an option.

"Liver transplant for colorectal metastases is an important evolution in transplant oncology and turns a historically palliative disease into one where cure is possible," says Dr. Croome.

It's a complex process that requires experts from multiple teams working together before transplant.

"Usually, it's at least six months of chemotherapy, and we would like to see that the tumors are responding and that we're not seeing any spread of disease anywhere else," he says. "We really want the disease to be isolated to the liver as the primary tumor. So the tumor in the colon needs to be removed ahead of time."

Liver transplants can significantly improve survival in advanced colorectal cancer, with five-year survival rates exceeding 70%.

"It's the care that patients receive leading up to that and afterward as well, and we really take pride in that," says Dr. Croome.

Related posts:

• Mayo Clinic Minute: Advancing colorectal cancer care through innovation and screening
• When a healthy life meets an unexpected colon cancer diagnosis
• Mayo Clinic Minute: AI advances help care teams find hard-to-see colon polyps

The post Mayo Clinic Minute: How liver transplant is transforming care for patients with advanced colorectal cancer appeared first on Mayo Clinic News Network.

As the trend continues, Mayo Clinic surgical teams are using innovative, minimally invasive approaches to treat colon and rectal cancer — helping patients recover faster after surgery.

Dr. Dozois says screening helps detect and treat colorectal cancer early, and improvements in surgery are helping patients maintain quality of life.

Watch: The Mayo Clinic Minute

Journalists: Broadcast-quality video (0:55) is in the downloads at the end of this post. Please courtesy: "Mayo Clinic News Network." Read the script.

"We are seeing a pattern of younger patients with colorectal cancer, and when I say younger, I mean patients under age 50," says Dr. Dozois.

Colon cancer is often treated with surgery.

"When we see patients with a new colon cancer, we're often recommending surgery, which is to remove a segment of the colon," he says.

Rectal cancer may require a combination of therapies.

"It may get treatment with chemotherapy, radiation and surgery. It might be all three, and that's what we call a multimodality approach," Dr. Dozois says.

Minimally invasive surgery, including laparoscopic and robotic approaches, uses small incisions, cameras and specialized instruments/

"Patients can recover more quickly, they have less complications, and they can get back to their activities and work in a much quicker fashion than they used to in the past," he says.

Importance of colorectal cancer screening

"Screening is critical. Why? Because it saves lives."

Related post:

• Mayo Clinic Minute: AI advances help care teams find hard-to-see colon polyps
• Mayo Clinic Q and A: So you’re having a colonoscopy: What to expect
• Mayo Clinic Minute: Warning signs of colorectal cancer in younger adults

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ROCHESTER, Minn. — Colon cancer is the third most prevalent form of cancer in the U.S., and its incidence is increasing among younger adults, particularly those younger than 50. While colon cancer screening has helped prevent and detect it before spreading, major advancements in treating colon cancer have been limited.

Now, new research led by Mayo Clinic Comprehensive Cancer Center found that adding immunotherapy to chemotherapy after surgery for patients with stage 3 (node-positive) colon cancer — and with a specific genetic makeup called deficient DNA mismatch repair (dMMR) — was associated with a 50% reduction in cancer recurrence and mortality compared to chemotherapy alone. Approximately 15% of people diagnosed with colon cancer exhibit dMMR, and, to date, these tumors have shown reduced sensitivity to chemotherapy. The results of the multicenter study were presented during a plenary session at the 2025 American Society of Clinical Oncology (ASCO) Annual Meeting in Chicago.

"The findings from our study represent a major advance in the adjuvant treatment of dMMR stage 3 colon cancer and will now change clinical practice," says Frank Sinicrope, M.D., a Mayo Clinic oncologist who led the study published in the New England Journal of Medicine. "It's very rewarding to be able to offer our patients a new treatment regimen that can reduce the risk of recurrence and improve their chances of survival."

Until now, the standard treatment after surgery for any stage 3 colon cancer has been chemotherapy. However, the researchers note that approximately 30% of patients with stage 3 tumors experience cancer recurrence despite this treatment.

Watch: Dr. Frank Sinicrope discusses Mayo Clinic immunotherapy study

Journalists: Broadcast-quality sound bites with Dr. Frank Sinicrope are in the downloads at the end of the post. Please "Courtesy: Mayo Clinic News Network."

The clinical trial enrolled 712 patients with dMMR stage 3 colon cancer that had been surgically removed and who had cancer cells in their lymph nodes. The immunotherapy given in this study was an immune checkpoint inhibitor, known as atezolizumab, which reactivates a person's anti-tumor immunity to enable the killing of cancer cells, which are responsible for cancer recurrence and spread. The patients — who lived in the U.S. and Germany — were randomized to receive chemotherapy for six months along with immunotherapy, with the immunotherapy continued alone for another six months versus the other study arm being chemotherapy alone.

Dr. Sinicrope and others previously studied patients with the type of colon cancer evaluated in the clinical trial, in which tumor cells cannot properly repair errors that occur when DNA is copied, due to dMMR. They noted that these patients' tumors showed a striking increase in inflammatory cells, including immune cells that are targets of immune checkpoint inhibitors. These findings provided the rationale for using immune checkpoint inhibitors as a strategy to enable immune cells to be more effective in attacking and killing cancer cells.  

Based on the data from the clinical trial, the combination of atezolizumab and chemotherapy represents a new standard treatment for stage 3 deficient mismatch repair colon cancer. The guidelines developed by the National Comprehensive Cancer Network, a nonprofit organization consisting of 33 leading cancer centers, including Mayo Clinic, have been updated to include this treatment recommendation. The guidelines also include patients with high-risk stage 2 colon cancer where the tumor invades or adheres to adjacent structures but does not involve lymph nodes. 

The study included patients with Lynch syndrome, the most common form of hereditary colon cancer, as these patients have tumors that show dMMR and are typically diagnosed at a younger age.

"We're changing the paradigm in colon cancer treatment. By using immunotherapy at earlier stages of disease, we are achieving meaningful benefits for our patients," says Dr. Sinicrope.

This study was developed by Dr. Sinicrope and conducted within the Alliance for Clinical Trials in Oncology, a National Cancer Institute-supported National Clinical Trials Network whose membership includes Mayo Clinic.

Review the study for a complete list of authors, disclosures and funding.

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About Mayo Clinic
Mayo Clinic is a nonprofit organization committed to innovation in clinical practice, education and research, and providing compassion, expertise and answers to everyone who needs healing. Visit the Mayo Clinic News Network for additional Mayo Clinic news.

About Mayo Clinic Comprehensive Cancer Center 
Designated as a comprehensive cancer center by the National Cancer Institute, Mayo Clinic Comprehensive Cancer Center is defining the cancer center of the future, focused on delivering the world's most exceptional patient-centered cancer care for everyone. At Mayo Clinic Comprehensive Cancer Center, a culture of innovation and collaboration is driving research breakthroughs in cancer detection, prevention and treatment to change lives.

Media contact:

• Julie Ferris-Tillman, Mayo Clinic Communications, newsbureau@mayo.edu

The post Immunotherapy boosts chemotherapy in combating stage 3 colon cancer appeared first on Mayo Clinic News Network.

Donna J. Gainer fuels her active lifestyle of hiking, bicycling and gardening with a health-conscious diet of mostly whole foods. So, when the 64-year-old received news that she had colorectal cancer in autumn 2025, a wave of emotions hit her.

"My first thought was the heartbreak I felt knowing I would have to call my son to tell him about the cancer diagnosis," recalls Donna. "My second thought was shock that I could have developed cancer with my lifestyle. A cancer diagnosis did not make sense."

Colon cancer screening

Donna's journey began in June 2025 after a colon cancer screening returned abnormal results. Her primary care physician then referred her to Mayo Clinic's Gastroenterology Department for a diagnostic colonoscopy, which identified two polyps in the bends of her colon and one near her appendix.

The complexity of Donna's colonoscopy results prompted further consultation with Dr. Michael Wallace, a Mayo Clinic gastroenterologist. Dr. Wallace shared that, in many cases around the world, large polyps at difficult-to-reach locations in the colon are typically removed surgically.

"Fortunately, here at Mayo Clinic, we have sophisticated techniques for removing even these advanced and large polyps through endoscopy or colonoscopy," says Dr. Wallace.

A review of Donna's case with a multidisciplinary care team led to a plan using two advanced treatments that reduced the risk of recurrence while mitigating the need for more intensive surgery: endoscopic submucosal dissection (ESD) and endoscopic mucosal resection.

Dr. Vivek Kumbhari, a Mayo Clinic gastroenterologist, partnered with Dr. Wallace on Donna's care.

"Care like this is never delivered in isolation. Before the procedure, Dr. Wallace and I carefully reviewed her case and determined that a comprehensive, single-session approach was in her best interest," says Dr. Kumbhari. "That level of collaboration ensures that every decision is thoughtful, evidence-based and tailored specifically to the patient. It's one of the defining strengths of Mayo Clinic."

Donna underwent her comprehensive endoscopic resection at Mayo Clinic in November 2025. She recalls feeling less apprehensive about undergoing the resection than the colonoscopy, citing the thorough yet compassionate care from Dr. Wallace and confidence in Dr. Kumbhari's expertise and ability to operate inside the colon.

"I felt really special that (Dr. Kumbhari) was the one doing my surgery," says Donna. "What meant the most was how warm and reassuring he was when he sat with me before surgery and explained everything. I felt truly blessed to have him as my surgeon."

During the single outpatient procedure, Dr. Kumbhari removed all three polyps without incisions, preserving Donna's organ function and quality of life.

"That is exactly what modern, patient-centered cancer care should look like," says Dr. Kumbhari. 

In a final review of Donna's case, her care team concluded that since Dr. Kumbhari removed all three polyps in one outpatient procedure using advanced techniques, further surgery and its associated risks — including sphincter injury, incontinence or colostomy — were not needed. Donna remains under close surveillance by Dr. Wallace, undergoing endoscopic ultrasound, CT scans and lab work every 90 days.

Since her procedure, Donna has returned to the lifestyle she enjoys, including her outdoor activities.

"I continue to live each day with gratitude, and I am humbled to have two brilliant and skilled surgeons who truly saved not only my colon, but my life," says Donna. "I was back to my daily routines within 24 hours, sometimes forgetting that I underwent a 3-hour procedure."

Donna raises awareness about colorectal cancer by sharing her story in the hope of inspiring even one person to get a screening colonoscopy, even if they consider themselves healthy.

"I want people to know that colon cancer is one of those diseases that can grow silently, without symptoms," says Donna. "Imparting that message is worth sharing a personal and private part of my life."

The post When a healthy life meets an unexpected colon cancer diagnosis appeared first on Mayo Clinic News Network.

JACKSONVILLE, Fla. — In a study published in NEJM Catalyst, Mayo Clinic researchers have demonstrated that chemotherapy can be safely delivered in patients' homes.

The study evaluated Mayo Clinic's Cancer CARE Beyond Walls (Connected Access and Remote Expertise), a model that combines virtual care, remote patient monitoring and in-home clinical services to deliver cancer treatment outside traditional infusion centers.

In the pilot study, a multidisciplinary team delivered 93 IV chemotherapy infusions to 10 patients in their homes. Researchers reported no treatment-related infusion reactions or catheter-related infections, supporting the safety and feasibility of this approach.

"Cancer care has traditionally required patients to spend long hours in infusion centers, often far from home," says Roxana Dronca, M.D., site director of the Mayo Clinic Comprehensive Cancer Center in Florida and director of Mayo Clinic Cancer CARE Beyond Walls. "This model allows us to safely bring high-quality care directly to patients, reducing burden while maintaining the standards patients expect from Mayo Clinic."

The study highlights the potential of home-based chemotherapy to reduce the physical, emotional and financial burdens associated with cancer treatment. Patients avoided travel time and experienced fewer disruptions to daily life while maintaining a continuous connection with their care team through virtual visits and remote monitoring.

Most participants surveyed reported high satisfaction with at-home care and said they would recommend the model to others.

"This approach is about more than convenience," Dr. Dronca says. "It's about improving quality of life during treatment and expanding access to care for patients who may face barriers to reaching traditional cancer centers."

To build on these findings, Mayo Clinic is still enrolling patients in a randomized clinical trial that launched in August 2023 to evaluate home-based chemotherapy compared with standard infusion care. This study will examine safety, patient experience, outcomes and costs, with the goal of expanding access to high-quality cancer care and reducing barriers to clinical trial participation.

Dr. Dronca is the first author of the pilot study, and Cheryl Willman, M.D., the Stephen and Barbara Slaggie Executive Director, Mayo Clinic Cancer Programs, is the senior author. For a complete list of authors, disclosures and funding, review the study.

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About Mayo Clinic
Mayo Clinic is a nonprofit organization committed to innovation in clinical practice, education and research, and providing compassion, expertise and answers to everyone who needs healing. Visit the Mayo Clinic News Network for additional Mayo Clinic news.

About Mayo Clinic Comprehensive Cancer Center
Designated as a comprehensive cancer center by the National Cancer Institute, Mayo Clinic Comprehensive Cancer Center is defining the cancer center of the future, focused on delivering the world's most exceptional patient-centered cancer care for everyone. At Mayo Clinic Comprehensive Cancer Center, a culture of innovation and collaboration is driving research breakthroughs in cancer detection, prevention and treatment to change lives.

Media contact:

• Julie Ferris-Tillman, Ph.D., Mayo Clinic Communications, newsbureau@mayo.edu

The post Mayo Clinic study demonstrates safety, feasibility of delivering chemotherapy at home appeared first on Mayo Clinic News Network.

March is Colorectal Cancer Awareness Month

ROCHESTER, Minn. — When someone is diagnosed with colorectal cancer — which includes both colon and rectal cancers — many people immediately think "surgery." And it’s true that surgery plays a central role in treatment for most patients. But whether it comes first, and what it entails, depends on several factors, especially where the cancer is located, how far it has grown into surrounding tissues, and whether it has spread, explains Eric Dozois, M.D., chair of colon and rectal surgery at Mayo Clinic in Minnesota.

"For colon cancer, surgery is typically the first and main step when the disease hasn't spread to distant organs. The goal is to remove the cancerous part of the colon along with nearby lymph nodes, which are the first places cancer spreads," Dr. Dozois says. "After surgery, the removed tissue is examined under a microscope to confirm the stage of the disease and decide whether additional treatment, such as chemotherapy, is needed."

In early-stage colon cancer (stages 1 and 2), surgery alone may be curative. Many patients won't need further treatment beyond regular follow-ups. In stage 3 disease, chemotherapy after surgery is usually recommended to help reduce the risk of the cancer returning.

Surgery also may be used in more advanced cases, including relieving symptoms like bleeding or bowel obstruction, or removing tumors in other organs, which might help control the disease, Dr. Dozois adds.

Rectal cancer, found in the last several inches of the large intestine, is often treated differently from colon cancer. Because the rectum is deep in the pelvis next to other organs and structures, such as nerves that control bowel and bladder function, doctors often use a multidisciplinary approach.

"For many rectal cancers, especially those that are locally advanced or close to critical structures, treatment typically begins with chemotherapy and radiation before surgery," Dr. Dozois says. "The aim is to shrink the tumor so it can be removed more completely and safely and reduce the risk that it will come back."

This sequence, called neoadjuvant therapy, is less common in colon cancer but standard in many cases of rectal cancer, which have a higher risk of local recurrence. It often improves outcomes and, in some carefully selected patients, may even allow preservation of more typical bowel function.

Rectal cancer care can involve a team of specialists, including colorectal surgeons, medical oncologists and radiation oncologists, who discuss each case together to tailor the best plan for each patient.

"Whether it's for colon or rectal cancer, the basic aim of surgery is the same: to remove the tumor completely, along with a margin of healthy tissue around it and nearby lymph nodes," Dr. Dozois says. "The surgeon then reconnects the remaining bowel so it can continue normal function."

Many colorectal operations are performed using minimally invasive techniques such as laparoscopy or robotic-assisted surgery, he adds. These methods use small incisions and advanced instruments that allow surgeons to work precisely, leading to fewer complications, less pain and a faster recovery than with traditional open surgery.

For colon cancer, minimally invasive colectomies are common and, in many patients, can be done through several very small incisions. Recovery may be quicker, with patients beginning to eat soon after surgery and returning home in a few days.

For rectal cancer, minimally invasive techniques also are used, but the surgery can be more complex because of the tighter space in the pelvis and the need to preserve nerves. Robotic surgery in particular offers 3D visualization and refined control that can be especially helpful.

Surgery for rectal cancer can sometimes affect bowel function. In some patients, a temporary or permanent stoma, an opening on the abdomen for waste to pass, may be necessary depending on the tumor's location and extent. Even with technically successful surgery, some patients experience changes in bowel habits or control (a condition sometimes called low anterior resection syndrome), urinary difficulties or sexual dysfunction. These are important aspects to discuss with your care team.

Not every colorectal cancer case is the same. The approach is individualized based on:

• Stage of the cancer: how deep it has penetrated and whether it has spread.
• Location of the tumor: rectal cancer often needs a different sequence of therapy than colon cancer.
• Overall health and preferences: patient goals, other medical conditions and recovery expectations all matter.

"Experience matters when it comes to optimizing outcomes in patients with colorectal cancer," Dr. Dozois explains. "That's why it's important to seek care from expert centers that treat a high volume of patients with colorectal cancer each year, use multidisciplinary teams to review each case, and recommend a therapeutic sequence that balances cure and quality of life."

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About Mayo Clinic
Mayo Clinic is a nonprofit organization committed to innovation in clinical practice, education and research, and providing compassion, expertise and answers to everyone who needs healing. Visit the Mayo Clinic News Network for additional Mayo Clinic news.

Media contact:

• Chloe Corey, Mayo Clinic Communications, newsbureau@mayo.edu
   

The post Surgery plays a central role in treatment for colorectal cancer – and is usually the first step appeared first on Mayo Clinic News Network.

Watch: The Mayo Clinic Minute

Journalists: Broadcast-quality video (1:09) is in the downloads at the end of this post. Please courtesy: "Mayo Clinic News Network." Read the script.

Polyps in the colon can vary in size and shape. Some are more mushroom-shaped, but that's not always the case. 

"Some polyps spread out more like a bed of moss; they're flat," says Dr. Wallace.

Advances in imaging and tools help care teams detect and treat difficult polyps. 

"Technology has been clearly shown to improve our ability to find more polyps and reduce the miss rate for some of these flat, subtle polyps," says Dr. Wallace. 

Early detection leads to better outcomes. 

"Stage 1 cancer, so-called T1 cancer, we can actually remove that through an endoscope or through a colonoscope, specifically, in a curative way," says Dr. Wallace. "This is something that has had profound implications for patient care." 

Dr. Wallace adds that the most important step is to get screened. 

"Whatever test you choose, get screened," Dr. Wallace says. "This is a preventable cancer. It's one of the very few cancers that we can almost completely prevent. So getting screened starting at the age of 45 — one caveat is — if you have a family history of colon cancer, you need to start even earlier."

Related posts:

• Mayo Clinic Q&A: Treating colorectal cancer with surgery
• (VIDEO) Transforming colon cancer care through precision medicine
• (VIDEO) Treatment options for advanced colorectal cancer

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